Carter BloodCare Crossmatch Services Manual
1.1 History
1.2 Mission Statement
1.3 Vision Statement
1.4 Accreditation
1.5 Department Descriptions and Contact Directory
1.6 Forms
Bedford Organizational Chart
Tyler Organizational Chart
2.1 Quality Policy Statement
2.2 Quarantine Notices
2.2.1 Quarantine/Lookback Notices
2.3 Recall/Market Withdrawal Notices
2.4 Quality Assurance Consultation Services
2.5 Forms
DPF400.20A Quarantine Request Facsimile
DPF400.20B Quarantine Release Request Facsimile
QAF403.01 Suspected Component Contamination Notification
QAF601.01A Component Recall Market Withdrawal Notification
QAF601.01B Quarantine-Release Notification
QAF602.01 Consignee Notification Record
QAF602.01.01 Reac Non-Descrim Multiplex HIV-1--HCV Assay Notification
RAF601.00 Request for Product Quarantine RADE
RTF120.11A Request for Product Quarantine, Discard or Retrieval
RTF120.11D Reference & Transfusion Suspected Component Contamination Notification
3.1 Disaster Plan
3.1.1 Coordinating the Local Blood Supply During Disasters
3.1.1.1 Purpose
3.1.1.2 Introduction
3.1.2 Glossary of Terms
3.1.3 Carter BloodCare’s Responsibilities
3.1.4 Customer’s Responsibilities
3.1.4.1 Pre-Disaster Preparation Checklist
3.1.4.2 During the Disaster
3.1.4.3 Working with the Media
3.1.5 Biological Attack Response Process
3.1.6 Regulatory Concerns
3.1.7 Handling Internal Disasters at Carter BloodCare
3.2 Blood Service Agreement Statement
3.3 Finance and Billing Policies
3.3.1 Third Party Payments
3.3.2 Payment Options
3.3.3 Billing Periods
3.3.4 Payment Terms
3.3.5 Billing Transaction Document
3.3.6 Weekly Invoices
3.3.7 Credit Memo
3.3.8 Debit Memo
3.3.9 Return Slip
3.3.11 Pack List
3.3.12 Financial Questions
3.4 Notification of Policy Changes
3.5 Forms
Credit Memo
Debit Memo
Pack List
Return Slip
Weekly Invoice
4.1 General Customer Complaints, Comments, and Customer Incidents
4.2 Customer Surveys
4.3 Forms
QSF702.01;Customer Incident
5.1 Neighborhood Donor Centers
5.2 Blood Drive Information
5.3 Health Fairs
6.1 Autologous Donations
6.1.1 Autologous Blood Donation Request
6.1.2 Autologous Blood Donation Criteria
6.1.3 Autologous Donation Scheduling
6.1.4 Facility Notification of Autologous Donation
6.1.5 Autologous Labeling
6.1.6 Low Weight/Volume Autologous Red Cells
6.1.7 Autologous Unit Testing
6.1.8 Special Considerations
6.1.9 Policy for Freezing Autologous Red Blood Cells
6.2 Restricted Donations
6.3 Therapeutic Phlebotomy
6.3.1 Therapeutic Donor Request
6.3.2 Therapeutic Donation Criteria
6.3.3 Therapeutic Phlebotomy Scheduling
6.3.4 Associated Fee
6.3.5 Unit Disposition
6.4 Hereditary Hemochromatosis (HH) and Testosterone Replacement Therapy (TRT) Programs
6.4.1 Donor Meets Eligibility Criteria and has a Draw Frequency of >8 Weeks
6.4.2 Donor Does not meet Eligibility Criteria &/or Requires a Draw Frequency of <8 weeks
6.5 Forms
6.5.1 Autologous Forms
SDF801.01, Autologous Blood Donation Request
SDF8001.01B, Autologous Worksheet
SDF801.01C, Donation Attempt Notification Letter to Hospital
SDF802.01A, Autologous Blood with Abnormal Test Result Notification
SDF801.01E, Frozen Autologous Red Blood Cell – Management Record
DCL255, Autologous Tie Tag (double sided)
Autologous Donation Information
6.5.2 Restricted, Therapeutic, HH and LOT Forms
DCL500, Restricted Donation tie tag (orange)
SDF801.03, Therapeutic Donor Request
Therapeutic Donation Information
DNF104.35C Enrollment/Prescription for No-Fee Phlebotomy for Hereditary Hemochromatosis (HH) Patients Only
DNF104.35D Enrollment/Prescription for Phlebotomy Due to Testosterone Replacement Therapy (TRT)
7.1 Components Provided
7.2 Component Manipulation Services
7.3 Donor Unit Testing
7.3.1 Routine Testing
7.3.2 Other Tests Performed as Indicated
7.4 Testing and Labeling
7.5 Placing an Order
7.6 Specimen Collection and Preparation
7.7 Unacceptable Specimens
7.8 Specimen Shipping
7.8.1 Sample Shipping Requirements
7.8.2 Sample Delivery
7.9 Test Turn-Around-Time (TAT)
7.10 Test Cancellation
7.11 Results and Reports
7.12 Forms
Acceptable Plasma Example (1)
Acceptable Plasma Example (2)
HSL200, Carter BloodCare Platelet Apheresis Tag
TLF200.00A; Remote Testing Requisition Form
7.13 Acceptable Plasma Examples
9.1 General Policies
9.1.1 Contract
9.1.2 Sample Shipping Requirements
9.1.3 Order Deliveries
9.1.4 Sample Rejection
9.1.5 Results and Reports
9.1.6 Crossmatched Product Return Policy
9.1.7 Test Cancellation
9.2 Test Priority and Turn-Around-Time (TAT)
9.2.1 Sample Shipping and Delivery TAT
9.2.2 STAT Order
9.2.3 ASAP (As Soon As Possible) Order
9.2.4 Routine Order
9.2.5 Test Priority Turn-Around-Time Summary Table
9.3 Forms
RTF102.03 Immunohematology Final Report
RTF102.04 Preliminary Report
RTF102.07B Crossmatch Account Report
RTF102.07D Crossmatch Account Report (electronic report)
RTF104.15 Reference and Transfusion Specimen Rejection Report
Example Forms
DPF-300.03B Request for Pick-up of Units for Return
HRDF100.01A Transfusing Facility Medical Director Checklist
HRDF100.01B Initial and Annual Storage Checklist
10.1 Testing Procedures
10.1.1 Type and Screen
10.1.2 Crossmatched Red Blood Cells
10.1.3 Autologous Red Blood Cells
10.1.4 Fresh Frozen Plasma, Platelets, or Cryoprecipitate
10.1.5 Antibody Identification and Antigen Negative Red Blood Cells Components
10.2 Ordering Procedures
10.2.1 Requisition Completion for Crossmatch Services
10.2.2 Blood Bank ID Armbands
10.2.3 Patient Identification
10.2.4 Blood Sample Collection
10.2.5 Completion and Delivery
10.3 Blood Administration
10.3.1 Positive Identification of Intended Recipient
10.3.2 Compatible IV Solutions
10.3.3 Blood Warming
10.3.4 Following Component Infusion
10.4 Adverse Reactions to Transfusions
10.5 Emergency Release of Untested Components
10.5.1 Compatibility Testing Not Completed
10.5.2 Infectious Disease Testing Not Completed
10.6 Release of Incompatible Red Cells
10.7 Platelet Testing Services
10.7.1 Platelet Serology
10.7.2 HLA Matching
10.7.3 Platelet Antibody Screening and Crossmatching
10.7.4 Sample Requirements
10.7.5 Requisition for Platelet Serological Testing
10.7.6 Platelet Labeling
10.8 Granulocyte Product Order
10.9 Forms
APL100 Crossmatched Apheresis Product Tag
APL100 Crossmatch Apheresis Product Tag
RTF101.01D Crossmatch Account Services Request Form
RTF206.05 Uncrossmatched or Incompatible Product Release
RTF214.03 Untested Product Release
RTL214.01 Emergency Release Uncrossmatched Blood Label
RTL214.03A Previous Donation Results Label
RTL214.03B Testing Not Performed Label
RTL422.01 HLA Matched Tie Tag
Crossmatch Compatibility Tag
Non-Crossmatch Compatibility Tag
RTL207.01A Confirmed Antigen Typing Label
RTL207.01C Molecular Matched Antigen Typing Tag
RTF205.13A Granulocyte Product Order & Physician Release Form
11.1 Reporting Adverse Reactions
11.1.1. Definition
11.1.2. Types of Adverse Transfusion Reactions
11.1.3 Transfusion Related Fatalities
11.1.4 Reporting a Suspected Transfusion Reaction
11.1.5 Recommended Actions if a Suspected Transfusion Reaction Occurs
11.1.6 To Initiate a Transfusion Reaction Investigation Work-up
11.1.7 Carter BloodCare Transfusion Reaction Investigation
11.2 Suspected Cases of Transfusion-Associated Infection
11.2.1 Notification to Carter BloodCare
11.2.2 Other Notification
11.2.3 Carter BloodCare Investigation
11.3 Reporting Transfusion Related Lung Injury (TRALI)
11.4 Forms
RTF215.01A Transfusion Reaction Investigation
RTF195.03A Transfusion Reaction Investigation Preliminary Report
RTF195.03BTransfusion Reaction Investigation Final Report
DNF106.02A Report of Suspected Transfusion Associated Infection
DNF106.30A Report of Transfusion-Related Acute Lung Injury Investigation
DNF106.30D Suspected TRALI Investigation Summary
12.1 Suggested Services
13.1 Therapeutic Apheresis Services
13.2 Diseases which may be treated by Apheresis
13.3 Contract/Privileges
13.4 Emergency Privileges
13.5 Granulocyte Orders
14.1 Overview
14.2 Contract/Privileges
14.3 Emergency Privileges
14.4 Product Collection, Processing, and Infusion
14.4.1 Collections of Peripheral Blood Stem Cells
14.4.2 Institutional Responsibilities for PBSC Collection
14.4.3 Donor Prescreen for PBSC and Marrow Collection
14.4.4 Assisting with Surgical Harvest of Bone Marrow
14.4.5 Processing and Cryopreservation
14.4.6 Product Storage
14.4.7 Thawing and Infusion
14.5 Forms
HPF170.06 Infectious Disease Tube Collection Form
15.1 Carter BloodCare Tours
15.2 Hospital Forums
15.3 Staff In-services
15.4 External Audits Performed for Transfusion Services
15.5 Known Samples Provided
15.6 Reimbursement Review for Blood Product Coding
15.7 Transfusion Medicine Fellowship Rotation
15.8 Resident Pathologist Blood Center Rotation
15.9 Medical Student Blood Center Community visits